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In Melty Blood Act Cadenza, almost all events that occur in the story-modes of the characters in this game are set in events based on alternate realities and different timelines that are totally out of current chronological timeline of Tsukihime/Melty Blood series (except certain story-modes of some characters).

There are those that are causing problems, and these enemies were generated and materialized by TATARI phenomenon caused by Wallachia, like if the first time they appeared in Misaki Town to terrorize the population (Shiki Nanaya, Red Arcueid and Kouma Kishima), and there are also those that appear during the confusion caused by TATARI phenomenon this same alternate reality, only to pursue their own personal goals (Akiha Vermilion and Mech-Hisui).

Act Cadenza was the first version of the original Melty Blood line to be an arcade game (for Sega NAOMI), and later became the first Melty Blood game on a console when it ported to the PlayStation 2. After that, it was ported to the PC.

It was also the first Melty Blood game not developed by French Bread, though the game was more of a port of Re-ACT than an entirely new game.

Melty Blood: Act Cadenza Ver. B is an arcade port of the PS2 game with various changes and upgrades, the most notable of which is the inclusion of 'White Len' as an initial playable character and Neco-Arc Chaos as a hidden character.

Melty Blood: Act Cadenza ver.B PC is a Windows PC port of the arcade ver.B2. It has added features including tag-team mode, a 4-player team battle mode, and a new hidden boss character, Neco-Arc Chaos Black G666 (replacing G-Akiha from Melty Blood Re-ACT). It was released on July 27, 2007.